A four-month investigation shows that poor decision-making and judgement led to the explosion

Up
until this point, it's been common knowledge that an explosion on the
Deepwater Horizon led to the oil leak in the Gulf of Mexico. But now,
BP has released
a report that lists the causes which led to the explosion,
the death of 11 people, and the worst
oil leak in U.S. history.

"The
investigation report provides critical new information on the causes
of this terrible accident," said Tony Hayward, BP's chief
executive. "It is evident that a series of complex events,
rather than a single mistake or failure, led
to the tragedy. Multiple parties, including BP, Halliburton and
Transocean, were involved."

Mark
Bly, BP's Head of Safety and Operations, along with over 50 technical
and other specialists that are both internal and external to BP, led
a four-month investigation in order to compile information for the
report and list the multiple causes associated with BP's oil spill.

According
to the report, several factors led to the oil leak, such as cement
and shoe track barriers failing to contain hydrocarbons within the
reservoir, allowing liquids and gas to to flow up production casing.
The Transocean crew did not act on the influx of hydrocarbons into
the well until they were in
the riser; well integrity had not yet been established, and BP
and Transocean accepted the results of the negative pressure test
incorrectly; the rig's fire and gas system failed to detect and
prevent ignition when the flow of gas entered engine rooms through
the ventilation systems; and the rig's blow-out preventer did not
activate automatically to seal the well after the explosion disabled
crew-operated controls.

The
report concluded that several different work teams and companies made
poor decisions which led to "a complex and interlinked series of
mechanical failures, human judgements, engineering design,
operational implementation and team interfaces."

The
report not only listed causes of the disaster, but also provided
recommendations for the companies involved (specifically BP) to
ensure that proper precautions are taken to prevent this type of
event from ever occurring again. The recommendations aimed to improve
well control, emergency systems, blow-out preventers, cement
testing, personnel
competance, pressure-testing for well integrity and rig audit and
verification.

"I
believe this report will be of significant value in helping the
overall understanding of how this tragedy occurred," said
Carl-Henric Svanberg, Chairman of the Board. "It is if the
utmost importance to the Board to ensure that BP learns from this and
further enhances the safety of its operations for the future."

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